BREAKING NEWS: ASIPP Submits Non-Partisan Budget Reconciliation Proposal for Physician Payment Reform
Recently, ASIPP submitted to members of Congress, a non-partisan proposal for budget reconciliation for the preservation of Medicare and Medicaid and the reform of the physician payment system.
This proposal is in response to the escalation of health care spending in the United States, which in 2023 was close to $4.9 trillion, a 7.5% increase from the previous year the Congressional Budget Office (CBO), and other sources indicate that net Medicare spending—after accounting for beneficiary premiums—is projected to total $14 trillion over the next decade. Simultaneously, the financial sustainability of physician practices is increasingly under pressure.
Over the past 24 years, physician payment rates have declined by 33%, while practice costs have steadily risen. The cost of medical equipment, supplies, and technology has grown from $30.2 billion in 2017 to $57 billion in 2023, reflecting an average annual growth rate of 6.5%. The overall increase in practice expenses may be even greater, compounding the financial challenges faced by providers. Additionally, a widening gap has emerged: while physician payments have declined, other health care sector payments have continued to rise. Perhaps the most striking is the contrast between insurance premium growth and physician reimbursement rates, with premiums increasing nearly 400% while physician payments have dropped by 33%.
ASIPP’s recommendations build upon previous analyses from MedPAC, CMS, OIG-HHS, and the CBO. The largest projected savings are expected to result from proposed reforms to the Medicare Advantage program exceeding 120 billion per year. Exceeding 120 billion per year, with an estimated savings from specific changes which include:
• Cancellation of the proposed 4.3% payment increase for 2026:
$21 billion per year, or $210 billion over 10 years
• Elimination of payments for veterans already covered by VA insurance:
$15 billion per year, or $150 billion over 10 years
• Ending favorable selection practices: $44 billion per year, or $440 billion over 10 years
• Reforming risk adjustment mechanisms:
$40 billion per year, or $400 billion over 10 years
Collectively, these measures would generate an estimated $120 billion in annual savings from the Medicare Advantage program—totaling $1.2 trillion over a 10-year period.
ASIPP will be providing the full 48-page Budget Reconciliation proposal at the ASIPP Annual Meeting to all ASIPP-PAC donors. We hope you will be able to join us at the meeting next week. If you cannot, you can send your PAC contribution using the following link and we will mail you a copy of the proposal. Click HERE to contribute to the ASIPP-PAC.
We cannot emphasize strongly enough how important your contributions are to the work we do toward the preservation of healthcare and especially interventional pain management.
